Rec Fee Refund Form

First Name

Last Name

Email Address

8-Digit University ID Number

Phone Number

Semester you were a Student and Employee

Today's Date

By submitting this form, I understand that to be considered for a refund, the University employee must submit this form no later than the last day of classes for the semester which a refund is requested.

Yes, I understand the statement

Math question (7 + 1 =)

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.